Nakamura Fumihiko, Valadon Crystal, Cope Zebulun, Talluri Sriharsha, Chou Brandon, Thompson Jannah, Ankem Murali, Choi Kellen
Department of Urology, University of Louisville School of Medicine, Louisville, USA.
Department of Obstetrics and Gynecology, University of Louisville School of Medicine, Louisville, USA.
Cureus. 2023 Dec 8;15(12):e50173. doi: 10.7759/cureus.50173. eCollection 2023 Dec.
Urology has shown a gradual decrease in the number of graduating residents who plan to pursue a career in academic medicine. Our objective was to identify barriers to academic urology, present options to mitigate those barriers, and explore strategic ways to encourage trainees to seek careers in academic urology. The authors performed a contemporary review of relevant articles through PubMed assessing prior survey studies, editorials, and expert opinion articles that evaluated academic urology, perceptions of academic medicine, physician burnout, and barriers that have been identified to pursuing careers in academic medicine. Selected articles were then independently reviewed by three authors for relevance and application of factors mitigating perceived barriers to pursuing a career in academic medicine, specifically academic urology. Barriers at the academic levels of medical school and residency were found to consist of the following: lack of exposure to research early in their medical careers, inadequate mentorship, all-specialty leading levels of burnout, current average levels of medical school indebtedness contrasted to perceptions of pay disparity when compared to private practice urologists' income, and perceptions of difficulty in maintaining the academic "triple threat." More acutely, the decision to make Step 1 a pass/fail exam, with the addition of historically low match rates in urology, have resulted in additional complications and concerns for aspiring academic urologists. There are clear barriers that graduating urology residents encounter when considering a career in academic medicine. In this review, we present possible mitigating factors that may be instituted at the individual, medical school, and postgraduate levels to increase the number of practicing academics.
计划从事学术医学职业的泌尿外科住院医师毕业生数量呈逐渐下降趋势。我们的目标是确定学术泌尿外科的障碍，提出减轻这些障碍的方法，并探索鼓励学员从事学术泌尿外科职业的战略途径。作者通过PubMed对相关文章进行了当代综述，评估了先前的调查研究、社论和专家意见文章，这些文章评估了学术泌尿外科、对学术医学的看法、医生职业倦怠以及在从事学术医学职业方面已确定的障碍。然后，三位作者独立审查所选文章，以确定减轻从事学术医学职业（特别是学术泌尿外科）所感知障碍的因素的相关性和适用性。医学院校和住院医师培训阶段在学术层面的障碍包括：在其医学职业生涯早期缺乏研究接触机会、指导不足、各专业普遍存在的职业倦怠、当前医学院校债务的平均水平与与私人执业泌尿外科医生收入相比的薪酬差距认知形成对比，以及对维持学术“三重威胁”难度的认知。更严峻的是，将美国医师执照考试第一步改为及格/不及格考试，再加上泌尿外科历来较低的匹配率，给有志于从事学术泌尿外科的医生带来了更多的复杂情况和担忧。泌尿外科住院医师在考虑从事学术医学职业时会遇到明显的障碍。在本综述中，我们提出了可能在个人、医学院校和研究生阶段实施的缓解因素，以增加从事学术工作的人数。
